Recent Releases In Global Health

As the 193 WHO member states gather at next week’s World Health Assembly (WHA) “a draft global code of practice on the international recruitment of health personnel will be on the agenda. Negotiation and adoption of a WHO code of practice is an unprecedented opportunity to advance global consensus to address the critical challenges of migration of health workers and its effect on health systems worldwide,” the authors of a LancetÂ Comment write. The piece lays out the key elements of the code and concludes, “although legally non-binding, the adoption of the draft code with its strong procedural and institutional mechanisms in place will be a definitive first step towards strengthening international cooperation and ensuring the viability of health systems worldwide”Â (Taylor/Gostin, 5/15).

A Lancet Comment examines the results of a study, which found that vitamin A supplements do not reduce maternal death rates. The article outlines the study’s possible policy implications. “If we are to provide policy makers with new options, how can we design trials that can be completed within a reasonable timeframe? â€¦ To get results within 3 years will require multisite trials, simple surveillance procedures to measure maternal deaths in communities, and donors willing to put up millions of pounds for studies that cover large and poor populations. There have been few trials of interventions to reduce maternal mortality ratios, and we need new evidence of effectiveness at scale if we are to reduce the unacceptable toll of maternal mortality,” the authors write (Costello/Osrin, 5/15).

A study in the CDC’s Morbidity and Mortality Weekly Report examines progress made in the goal of global wild poliovirus (WPV) eradication in 2009. “During 2009 a total of 1,606 cases of WPV infection were reported, compared with 1,651 in 2008,” the report notes, providing information on the countries where outbreaks occurred. To maintain goals of polio eradication, the report writes two factors must be present: “addressing local barriers to interrupting transmission, and â€¦ using bivalent oral poliovirus vaccine (bOPV) broadly for WPV 1 and 3 in supplemental immunization activities (SIAs)” (5/14).

The latest edition of the journal Health Communication focuses on polio. The articles examine how the experience with polio could inform future disease eradication efforts, including the ongoing effort to eliminate polio (5/7).Â

The “Global Poverty” blog features a reflection on the U.S. role in the global fight against HIV/AIDS in light of one of the New York Times reports. The writer states: “Instead of losing ground on one front in order to gain on another, we should explore creative methods to finance all the work that needs to be done by demanding a stronger commitment from global leaders and the U.S. Congress. More broadly, we must support the Foreign Assistance Revitalization and Accountability Act (S. 1524) introduced in July 2009” (Messinger, 5/12).

A “Global Health Policy” blog post notes: “These articles are a welcome blast of frank information about the difficulties faced by those with AIDS and those battling the epidemic on the front lines in Africa. However, the headline and the tone of the first and last of these articles is misleading. They give the impression that existing efforts, which have previously been successful, have stopped working. This characterization of the situation is largely false in the case of AIDS treatment and not even entirely true in the case of HIV prevention.” After an analysis, the writer concludes, “If we can’t treat everybody, what should we aim to do? â€¦ We must shift now to achieve an AIDS Transition: invest massively in prevention to reduce the number of new infections, so that, eventually, we will be able to attain high levels of treatment coverage AND have a declining number of people who are infected with HIV” (Over, 5/12).

Obama Names U.S. Delegates For Upcoming World Health Assembly

President Barack Obama on Tuesday announced the names of the U.S. delegates to the 63rd World Health Assembly (WHA) of the WHO May 17-21, 2010, according to a White House press release. The delegates include: HHS Secretary Kathleen Sebelius, chief delegate; Betty King, permanent representative of the U.S. to the European office of the U.N.; Nils Daulaire, director, Office of Global Health Affairs, Department of Health and Human Services. The press release also lists the names of individuals designated as Alternate U.S. Delegates to the WHA (5/12).

Blogs Report On Capitol Hill Activities

Several blogs covered global health-related activity on Capitol Hill.

“Research!America” reports on the briefing, “Lessons Learned Through Global Health R&D â€“ What’s in it for the U.S. and Our Health Care System,” which examined how the “U.S. investment in global health research offers the opportunity to think about U.S. health care in new ways” (5/12).

“Five Republican U.S. senators recently sent a pointed letter to U.S. Global AIDS Ambassador Eric Goosby, MD, asking for a clear response to reports that patients are being denied HIV therapy in Uganda and that clinicians elsewhere are ‘being forced to ration lifesaving treatment,'” according to the “Science Speaks” blog, which includes a full text of the letter (Shesgreen, 5/12).

“Science Speaks” also reports on a Congressional briefing, which dealt with HIV/AIDS funding. “AIDS experts expressed grave concern about a shift in the focus of the U.S. President’s Emergency Plan for AIDS Relief, from providing HIV treatment to patients to providing technical assistance to developing country governments,” the blog notes. It includes quotes from advocates’ testimonies (Shesgreen, 5/11).

A PLoS One article examines how many drugsÂ were approved for neglected diseases between 1975 and 1999. Though “[p]roduct approvals for neglected diseases have increased, â€¦ progress has been uneven, with malaria appearing to benefit most in the short run from increased funding, while less success has been booked in other disease categories,” according to the study. “This suggests the infusion of more money itself is insufficient, while better targeting of funds may be warranted. Moreover, a balanced comprehensive approach to address the neglected disease problem will involve not only drug development but also attention paid to public health infrastructure and capacity-building to improve access,” the report concludes (Cohen/Dibner/Wilson, 5/12).

Rep. Lois CappsÂ (D-Calif.) on Tuesday introducedÂ the Global MOMS Act to “authorize assistance to improve maternal and newborn health in developing countries.” The proposed bill would also require the president “to develop a strategy to reduce mortality and improve maternal and newborn health in developing countries” and authorizes the appropriations of “such sums as may be necessary for each of fiscal years 2011 through 2015.” More information on recent U.S. global health policy developments is available on Kaiser’s Policy Tracker tool (5/11).

A PLoS Medicine Perspective piece about global health diplomacy traces the creation of PEPFAR, highlights the U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Global Alliance for Vaccines and Immunization (GAVI), and details the plans for President Barack Obama’s Global Health Initiative. The piece also highlights how the U.S. responded to the H1N1 (swine flu) pandemic, by donating 10 percent of the country’s H1N1 vaccine supply to the WHO for distribution in developing countries.

“Experience in addressing HIV/AIDS and H1N1 shows clearly that addressing global health challenges with diplomacy and development strategies is essential. … A second message taken from HIV/AIDS and H1N1 experiencesÂ is the importance of partnerships,” the piece notes. “Today we face a range of issues that confront our nation and the world and that must be addressed to ensure stability and security. Global health is such an issue” (Jones, 5/11).

A PLoS Medicine Perspective piece reflects on the growing awareness of the “inter-linkages between health and foreign policy” among foreign policy leaders and the growth of global health diplomacy at U.N. and WHO levels. “In support of effective health governance, better evidence and best practices are needed on how foreign policy can improve policy coordination at all levels and create an improved global policy environment for health,” the piece concludes. “Foreign policy practitioners need to become more aware of positive and negative impact of policy options and decisions on health outcomes. This is how foreign policy can make a difference to health” (Mogedal/Alveberg, 5/11).

Blog: New U.S. Strategy To Address Malnutrition

Secretary of State Hillary Rodham Clinton recently announced a new strategy aimed at addressing malnutrition and undernutrition in developing countries, “The Development Newswire” blogÂ reports. “We’re identifying millions of young children who need nutritional support and we’re sticking with them for a three-year period to give them a foundation to lead healthy lives,” Clinton said at the CARE’s annual conference. “She explained that nutrition has the biggest impact on a person’s life during the first 1,000 days of his or her life, which cover the start of pregnancy through the second year of life,” the blog writes. The Obama administration wants to “make nutrition the intersection” of the Global Health Initiative and Feed the Future (Mungcal, 5/12). The State Department’s website has a full transcript and video of the speech (5/11).

Blog: Clear Development Strategy Needed

The “Rethinking U.S. Foreign Assistance Blog” examines several U.S. government initiatives, such as Feed the Future, the Global Health Initiative and Congressional legislation, and their possible effects on foreign aid reform. “Without broader foreign aid reform, the administration and Congress must settle for more work-arounds and end up creating more fragmented and separate coordination systems in an effort to compensate for an imperfect system,” according to the blog. “What’s needed â€“ and has been asked for repeatedly by the development community â€“ is a clear development strategy that specifies the U.S.â€™s development goals and whoâ€™s in charge of achieving them” (Dunning, 5/11).

Blogs: WHO’s Regional Director for AfricaÂ Luis Sambo Speaks At CSIS

The WHO’s Regional Director for AfricaÂ Luis SamboÂ spokeÂ lastÂ Friday at theÂ Center for Strategic and International Studies (CSIS) “offer[ing] a progress report Friday on the Abuja Declarations on health, signed ten years ago by African heads of state,” the Commission on Smart Global Health Policy’s blog says.Â The post highlightsÂ elements of his discussion including the goals of “[s]trengthening partnerships and harmonization;Â [s]upporting health systems strengthening, [p]utting the health of mothers and children first; [s]upporting accelerated actions on HIV/AIDS, Malaria & TB,Â [i]ntensifying the prevention and control of neglected tropical diseases, non-communicable diseases and epidemics; [a]ccelerating the response to broader health determinants”Â (Poster, 5/11).Â Â

According to the “Science Speaks” blog, Sambo said that not all of the Abuja goals had been achieved, but that Sambo said many of the “successes were achieved thanks to external funding mechanisms, such as PEPFAR and the Global Fund.Â … Sambo also expressed high hopes for President Obama’s new Global Health Initiative, and expects it to be a powerful initiative that will bring many positive results.”Â The blog notes that Sambo expressed concerns about funding gaps and “said African nations need to take on more responsibilities and ownership of programs, and broaden their health policies to go beyond disease control”Â (Aziz, 5/8).Â